Exploring Billing Models for Family Physicians in Canada: What UK GPs Need to Know

Are you a UK GP considering a move to Canada? The prospect of practicing medicine in a new country can be both exciting and overwhelming. One of the most important factors to consider when relocating is how you'll be compensated for your work. Unlike the NHS model, Canada offers a range of billing systems that vary by province, each with its own advantages and potential earning opportunities. This blog will guide you through these billing models and help you understand where you can maximize your income as a Family Physician in Canada.

Overview of Billing Models Across Canada

Canada's healthcare system is publicly funded, but the way Family Physicians are paid varies significantly across the provinces. Here’s a quick breakdown of the most common billing models across the country:

Here is a simplified list of the billing models by province in Canada:

Billing Models Across Canadian Provinces:

1. Alberta:

- Fee-for-Service (FFS)

- Alternative Relationship Plan (ARP)

- Blended Capitation

2. British Columbia:

- Fee-for-Service (FFS)

- Longitudinal Family Physician (LFP) Payment

- Blended Payment

3. Manitoba:

- Fee-for-Service (FFS)

- Alternative Funding Arrangement (AFA)

4. New Brunswick:

- Fee-for-Service (FFS)

- Blended Capitation

5. Newfoundland & Labrador:

- Fee-for-Service (FFS)

- Salary

6. Nova Scotia:

- Fee-for-Service (FFS)

- Blended Capitation

- Alternate Payment Plan (APP)

7. Ontario:

- Fee-for-Service (FFS)

- Family Health Organization (FHO)

- Family Health Group (FHG)

- Family Health Network (FHN)

- Blended Salary

- Rural Northern Physician Group Agreement (RNPGA)

8. Prince Edward Island (PEI):

- Fee-for-Service (FFS)

- Salary

- Blended Payment

9. Quebec:

- Fee-for-Service (FFS)

- Mixed Remuneration

10. Saskatchewan:

- Fee-for-Service (FFS)

- Blended Capitation

- Salary

11. Yukon, Northwest Territories, Nunavut:

- Fee-for-Service (FFS)

- Salary

Now, let’s dive deeper into these billing models to understand how they work, along with their pros and cons.

1. Fee-for-Service (FFS)

How It Works: Under this model, Family Physicians are paid for each patient visit or service provided. Each consultation, procedure, or test is billed separately based on a provincial fee schedule.

Pros:

• Allows high earning potential based on patient volume.
• Flexibility in scheduling and types of services offered.

Cons:

• May lead to burnout due to high patient volume requirements.
• Focuses more on quantity rather than continuity of care.

Where This Model Excels: Ontario, Alberta, and British Columbia have robust FFS systems. Physicians who prefer flexibility and are capable of handling high patient volumes can thrive under this model.

2. Family Health Organization (FHO) - Ontario

How It Works: FHO is a blended capitation model where Family Physicians receive a fixed monthly payment per patient on their roster, regardless of how many times they see them. Additional payments are provided for services like preventive care and chronic disease management.

Pros:

• Stable and predictable income.
• Encourages continuity of care and comprehensive patient management.
• Physicians can earn bonuses through incentives for chronic care and preventive services.

Cons:

• Requires managing patient panels effectively.
• May be less lucrative for those who prefer to see a high volume of patients.

Where This Model Excels: Ontario. FHO is ideal for doctors looking to build long-term relationships with their patients and earn a stable income while focusing on preventive care.

3. Family Health Group (FHG) - Ontario

How It Works: The FHG model combines FFS payments with bonuses for after-hours care, patient enrolment, and preventive services. It’s a good middle-ground option for those who want to mix volume-based income with stability.

Pros:

• Flexibility to earn more based on patient volume.
• Incentives for comprehensive care, similar to FHO.
• Less restrictive than capitation-only models.

Cons:

• Income can fluctuate based on patient visits and availability for after-hours care.
• May require juggling a mix of volume and quality-based goals.

Where This Model Excels: Ontario. FHG suits physicians who want a balance between patient volume and stable incentives.

4. Blended Capitation

How It Works: Physicians receive a fixed payment per patient on their roster, regardless of how many times they see them. There are also incentives for certain services that encourage comprehensive care.

Pros:

• Stable income without the pressure of seeing more patients.
• Encourages continuity of care and preventive services.

Cons:

• Requires effective management of patient panels.
• May be less lucrative for physicians who want to maintain a high-volume practice.

Where This Model Excels: Ontario (through the Family Health Organization model) and Alberta both have options for capitation, which is ideal for those who prefer a steady income and focus on patient relationships.

5. Alternative Relationship Plan (ARP) - Alberta

How It Works: ARP is a mix of fixed payments and performance-based incentives, encouraging collaboration and comprehensive patient care.

Pros:

• Incentivizes teamwork and comprehensive care.
• Flexibility in delivering services.

Cons:

• Requires detailed tracking and reporting, which can be time-consuming.

Where This Model Excels: Alberta has been a leader in implementing ARPs, providing an excellent opportunity for physicians interested in working as part of a team.

6. Longitudinal Family Physician (LFP) Payment - British Columbia

How It Works: LFP provides a fixed rate per patient on the physician’s panel, promoting continuous care. Physicians can also bill for specific services not covered by the fixed payment.

Pros:

• Stable income.
• Encourages long-term patient care relationships.

Cons:

• Requires panel management.
• Less lucrative for high-volume practices.

Where This Model Excels: British Columbia’s new LFP model is designed to promote long-term patient care, making it a great fit for GPs who want to build lasting relationships with their patients.

7. Salary

How It Works: Physicians are paid a fixed annual salary, usually found in hospital settings or community health centers.

Pros:

• Stable, predictable income.
• Reduced administrative tasks.

Cons:

• Less financial incentive to see more patients.
• Can result in lower earnings compared to other models.

Where This Model Excels: Nova Scotia, Newfoundland, and rural areas often use salary-based systems, ideal for those who prioritize stability over high earnings.

Where Are the Highest Earning Opportunities?

• Ontario: Ontario has various models that provide flexibility and high earning potential. The Family Health Organization (FHO) model, with its blended capitation, offers a balance of stability and incentives for physicians who build strong patient rosters. Additionally, the FFS system in Ontario is lucrative for high-volume practices.
• Alberta: Physicians in Alberta can maximize their income through FFS and Alternative Relationship Plans (ARPs). The province's efficient healthcare system and large population centers provide a steady stream of patients.
• British Columbia: The new Longitudinal Family Physician model offers stability with opportunities for additional income through service-specific billing.

Earning Potential for Family Physicians

The earnings of Family Physicians can vary significantly based on the billing model, location, and patient volume. Here's a general idea of what you can expect:

• Fee-for-Service (Ontario, Alberta, BC): $250,000 - $400,000 CAD per year
• Blended Capitation (Ontario - FHO): $300,000 - $450,000 CAD per year
• Alternative Relationship Plan (Alberta): $300,000 - $500,000 CAD per year
• Longitudinal Family Physician Payment (BC): $250,000 - $400,000 CAD per year
• Salary (Rural Areas, PEI, Nova Scotia): $150,000 - $250,000 CAD per year

How to Decide Which Model Is Right for You

As a UK GP considering a move to Canada, it’s essential to evaluate your own career goals. Do you prefer a steady, predictable income, or are you looking for the flexibility to scale your earnings? Do you enjoy managing patient relationships over the long term, or do you prefer a fast-paced, high-volume environment? Your answers to these questions will help you decide which province and billing model will be the best fit for your career.

Why Move to Canada as a Family Physician?

• Higher Earning Potential: With attractive overhead splits and multiple billing models, Canada allows Family Physicians to maximize their income.
• Work-Life Balance: Depending on the billing model, you can maintain a desirable work-life balance while still earning a competitive income.
• Beautiful Locations: Provinces like Ontario, British Columbia, and Alberta offer stunning landscapes, vibrant cities, and a high standard of living.

Conclusion

Canada’s healthcare system offers multiple billing models, each with its own benefits and challenges. As a UK-trained GP, understanding these models can help you make an informed decision about relocating and setting up your practice in Canada. Whether you're looking for stability, high earning potential, or a balanced workload, there’s a billing model that will suit your needs.

If you’re ready to explore the possibilities of working as a Family Physician in Canada, Merrick Global Talent can help you find the perfect opportunity. Get in touch today, and let’s discuss your move to Canada!

Contact Us

For more information on how to get started, visit Merrick Global Talent or reach out directly to our team. We have helped many UK-trained GPs make the move, and we look forward to assisting you in this exciting journey!